Esophageal Cancer Treatments: Side Effects of Non-Surgical Approaches

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Esophageal Cancer Treatments: Side Effects of Non-Surgical Approaches

Esophageal Cancer Treatments: Side Effects of Non-Surgical Approaches

Treatment without surgery for esophageal cancer, what happens to esophageal cancer with radiotherapy and chemotherapy? what are the side effects of radiotherapy, chemotherapy, and immunotherapy?

Whether you are worried about having esophageal cancer or already have a diagnosis, it is important to have a solid understanding of the basics.

What are the characteristics of esophageal cancer? Understanding the current situation is the first step in dealing with it appropriately.

From “Everything You Need to Know About Esophageal Cancer,” let’s introduce immunotherapy for esophageal cancer and its side effects.

Esophageal Cancer Treatments: Side Effects of Non-Surgical Approaches

Immunotherapy: Some drugs enhance the immune system

The body naturally has a function called immunity, which tries to eliminate foreign substances. Treatment that utilizes this power is called “immunotherapy.”

A drug that has been proven effective as an immunotherapy for cancer and is now being used in the treatment of esophageal cancer is “immune checkpoint inhibitors.” It is a type of molecular targeted drug that acts only on specific proteins and has been recognized as one of the treatments covered by health insurance.

It is important to note that among the treatments called “immunotherapy,” there are many that have not been scientifically proven to be effective, including so-called folk remedies.

Esophageal cancer is about six times more common in men than in women, which is thought to be due to the fact that men are more likely to have lifestyles that increase the risk of esophageal cancer. Women should not be complacent just because they are women. It is necessary to reduce dangerous lifestyle habits regardless of gender.

Examples of Use: Immune checkpoint inhibitors used in the treatment of esophageal cancer include nivolumab (Opdivo®), pembrolizumab (Keytruda®), and ipilimumab (Yervoy®) (as of October 2023).

Preoperative chemoradiotherapy + adjuvant therapy after surgery If surgery is performed after chemoradiotherapy and the cancer is not completely gone, continuing nivolumab treatment has been shown to increase the 5-year survival rate. ▼ How to use Infusion at intervals of 2 to 4 weeks. Continue for 12 months.
Advanced or recurrent esophageal cancer that cannot be removed by surgery Combining immune checkpoint inhibitors with conventional chemotherapy extends the possibility of living longer compared to chemotherapy alone. However, depending on the patient’s condition, treatment may not be continued due to side effects, among other reasons. ▼ Combination methods

Pembrolizumab (Keytruda®) + chemotherapy (cisplatin + 5FU)
Nivolumab (Opdivo®) + chemotherapy (cisplatin + 5FU)
Nivolumab (Opdivo®) + ipilimumab (Yervoy®)

Side effects: There are side effects to immune checkpoint inhibitors Photo by iStock

Compared to chemotherapy, immune checkpoint inhibitors are said to have fewer side effects. However, it is important to note that there are cases where serious side effects such as interstitial pneumonia and type 1 diabetes occur due to the excessive strengthening of the immune system. In most cases, side effects due to excessive immune activity can be managed by using immunosuppressive drugs such as steroids.

Possible side effects: Fatigue, nausea, rash, itching, loss of appetite, diarrhea, anemia, interstitial pneumonia, colitis, thyroid dysfunction, type 1 diabetes, liver damage, etc.

Side Effects: Overcoming tough symptoms with medication From “Everything You Need to Know About Esophageal Cancer”

Chemotherapy and radiotherapy do not directly damage the body like surgical treatment. However, both chemotherapy and radiotherapy affect not only “cancer cells” but also healthy cells. Cells that divide rapidly, such as mucous membranes, hair roots, and cells that produce blood cells, are particularly susceptible to the effects of chemotherapy and radiotherapy, making various side effects more likely to occur.

However, there are individual differences in how side effects appear. There are also medications to suppress symptoms, and most symptoms will improve once the treatment is over.

Dealing with side effects Photo by iStock

Experiencing side effects cannot be avoided. Let’s overcome them while consulting with doctors and nurses.

Control with medication

Take medication in advance for possible side effects, or use medication according to the symptoms.
Nausea, vomiting, and fatigue can be alleviated with medication. Apply ointment for skin inflammation.
Decrease in white blood cells can be prevented to some extent with medication. Platelet and red blood cell decreases are supplemented by transfusion.

Innovations in daily life

When the skin becomes red and itchy, cooling it is effective.
After vomiting, rinsing with cold water or sucking on ice can make you feel better.
For outpatient treatment, prepare soft, non-irritating, and high-moisture meals.
Jelly or sherbet is a snack that is easy to eat.
People who are concerned about hair loss should prepare scarves or caps. It will return to normal in 3 to 4 months after treatment ends.

Serious side effects may require a review of treatment policies

If there is a significant decrease in liver or kidney function, the decision to continue treatment is made based on the degree of decrease.
If the decrease in blood cells does not recover easily, the timing of starting the next treatment may be reconsidered.